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Understanding Frozen Shoulder: Causes, Symptoms, and Management - Jasleen Pabla
Frozen shoulder, also known as adhesive capsulitis, is a painful condition characterized by a significant restriction of both active and passive shoulder movements. This self-limiting condition can greatly impact daily activities and quality of life. In this blog post, we will dive into the causes, symptoms, and stages of frozen shoulder, as well as management techniques to alleviate its effects.
Causes of Frozen Shoulder:
The exact cause of frozen shoulder remains uncertain.
However, it is often associated with immobility due to various conditions such as coronary artery disease, mastectomy, or cervical spondylosis. Not performing full shoulder stretches during daily activities may also lead to capsular contracture and eventually a stiff shoulder. While frozen shoulder is sometimes used to describe other painful shoulder conditions, it specifically refers to inflammation within the capsule and synovium of the shoulder joint.
Symptoms of Frozen Shoulder:
-Pain and stiffness that limit shoulder movement.
-Difficulty in performing overhead activities like hanging clothes.
-Pain that starts from the neck and radiates to the arm and hand.
-Night pain, making it hard to lie on the affected shoulder.
Stages of Frozen Shoulder:
Frozen shoulder progresses through three stages:
1. Freezing Stage (Initial Stage):
Painful and limited shoulder movement.
Muscle release and gentle mobilizations can help manage pain.
Acupuncture and specific exercises, such as pulley and Codman's exercises, may be beneficial.
2. Frozen Stage (Decreased Range of Motion):
Further reduction in shoulder movement.
Continued muscle release, stretches, and gentle mobilization.
Techniques like MWM (Mulligan's Mobilizations with Movement) to improve movement.
3. Thawing Stage:
Gradual return of shoulder movement.
'Strengthening exercises to maintain and control the range of motion.
Assessment of Frozen Shoulder
Assessment involves both subjective and objective evaluations:
Subjective Assessment:
-Detailed medical history and presenting conditions.
-Pain distribution and severity, especially night pain.
-Activities that aggravate pain, such as reaching overhead or fastening a seatbelt.
Objective Assessment:
Observation of reduced shoulder ranges of motion (ROM).
Specific shoulder tests like the Coracoid Pain Test and Shoulder Shrug Test to identify limitations.
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Management Techniques
Management of frozen shoulder should be tailored to the individual's stage of the condition:
Initial Stage:
-Pain management through muscle release and gentle mobilization.
-Acupuncture targeting specific points (ST-38, LI4, LI14, LI15, SI-9, GB-34).
-Exercises like pulley and Codman's exercises.
Second Stage:
-Continued muscle release and stretches.
-Specific joint mobilizations and MWM techniques.
Third Stage:
Strengthening exercises to maintain and regain full range of motion.
